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General NPI Number Information
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NPI Number | 1972787695
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Entity Type | Individual
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Provider Name | AUDIE L LEE P.A.-C.
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Gender | Male
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Dates
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Enumeration Date | 12/18/2007
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 2912 21ST AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94132-1504
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Country | US
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Telephone | 207-632-0741
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 276950
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City | SACRAMENTO
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State | CA
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Zip | 95827-6950
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA1413
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA19457
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License Number State | CA
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